What Should An M.D. Know About Chiropractors?

As a medical doctor, have you questioned what you really know about chiropractic training or the evidence supporting manipulation and other chiropractic approaches?

Are all chiropractors created equal?

How can you interview a chiropractor to identify someone you will trust and refer to?

The best-kept secret about chiropractors is their education. Chiropractic education consists of a minimum of a 4 year program. Because chiropractic colleges offer coursework during the summer months, chiropractic students can complete their education in three and a quarter to three and a half years.

The first 2 years are primarily devoted to the basic sciences. Course work is standardized by the Council on Chiropractic Education. As a result, the education is similar at all colleges. For example, subjects covered include histology, anatomy, embryology, physiology (separate courses for each system; e.g. GI/GU physiology), pathology (separate courses for each system; eg. cardiopulmonary pathology), microbiology, biochemistry, etc.

Clinical sciences include evaluation and management courses based on region with a focus on the spine and extremities (e.g. Evaluation of the Cervical Spine, Management of the Lumbar Spine, Evaluation and Management of the Upper Extremity).

Diagnosis coursework is usually extensive and includes physical diagnosis, differential diagnosis, laboratory diagnosis, and radiographic interpretation including special imaging.

In a comparison with most medical schools, chiropractic colleges offer more coursework in anatomy, radiology, nutrition, rehabilitation, and of course, manipulation.

Although in-depth coursework on pharmacology and surgery is not part of chiropractic education, chiropractors do receive training regarding the mechanisms of many common classifications of drugs and certainly in the potential side-effects that may influence a patient's complaint(s) and influence case management.

The clinical training component of the chiropractic program is context-specific meaning that given most chiropractors practice in private office settings, chiropractic training attempts to simulate that environment with at least one full year of training in an on-site college clinic and outreach clinics that are set up throughout the local community. Many colleges offer an externship in field offices.

Choosing a chiropractor to refer to or associate with can be difficult given the variety among chiropractic approaches. For assistance in making that decision, review the recommendations for patients who are, in essence, making a similar decision.